36例肺炎支原体感染患儿凝血功能变化分析

摘要

目的 探讨肺炎支原体感染对患儿凝血系统的影响及发病机制,为临床治疗儿童肺炎支原体感染提供依据.方法 前瞻性实验,采用病例对照研究方法,将2011年1月至2011年12月间来潍坊市人民医院住院治疗的36例肺炎支原体感染患儿作为实验组,其中肺炎支原体抗体(MP-IgM)为1∶80至1∶160为低滴度组,共17例；MP-IgM为1∶320至1∶1280为高滴度组,共19例；另外选取20例的同时期门诊健康查体儿童作为对照组.三组儿童体质量、年龄差异均无统计学意义(P＞0.05),具有可比性.分别测定三组儿童凝血常规六项及血浆D-二聚体定量等指标,采用SPSS 15.0软件进行统计学分析.结果 低滴度组和高滴度组儿童血浆纤维蛋白原定量(FIB)及D-二聚体定量均高于对照组儿童,差异均具有统计学意义(P＜0.05)；高滴度组儿童凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)均较对照组时间短,差异均具有统计学意义(P＜0.05).结论 肺炎支原体感染有潜在的可能激活外源性和内源性凝血系统,从而引起或促进血栓形成,重度感染容易导致患儿缺血性发作.%Objective To study the effect of Mycoplasma pneumoniae infection on the coagulation system in children and to clarify its mechanism in order to guide the therapeutic strategy for Mycoplasma pneumoniae infection in clinical practice.Methods A prospective and case control study was carried out in 36 children with Mycoplasma pneumoniae infection in Weifang People ' s Hospital from January through December in 2011.The 36 patients were divided into two groups according to the MP-IgM plasma titers,namely low-titer group with MP-IgM 1 ∶ 80-1 ∶ 160 (n =17) and high-titer group with MP-IgM 1 ∶ 320-1 ∶1280 (n =19).The subjects of control group (n =20) were recruited from healthy children as they took routine physical examination during the same period.Six indexes related to the coagulation function as well as D-dimer in plasma were determined.All data were analyzed by using SPSS 15.0 software.Results The levels of fibrinogen (FIB) and D-dimer in the low-titer group and high-titer group were significantly higher than those in the control group (P ＜ 0.05).The prothrombin (PT) and activated partial thromboplastin time (APTT) in the high-titer group were significantly shorter than those in the control group respectively (P ＜ 0.05).Conclusions Mycoplasma pneumoniae infection in children gives rise to the potential for activating the extrinsic and intrinsic coagulation system,promoting thrombosis and in turn inducing ischemic stroke in serious cases.